PNG 2254: Mental Health Nursing –
Exam 3 Questions and Answers with
Rationale Latest Edition 2026/2027
Question 1
A client is admitted to the psychiatric unit with a diagnosis of major
depressive disorder. The client is withdrawn, uncommunicative, and
sitting in a slumped posture. Which initial nursing intervention is most
therapeutic?
A. Leave the client alone until they feel like initiating a conversation.
B. Sit quietly with the client at frequent intervals, offering a
supportive and non-demanding presence.
C. Engage the client in a high-energy group activity immediately to
distract them.
D. Question the client persistently until they verbalize their
underlying feelings.
Correct Answer: B
Rationale: A withdrawn, depressed client often lacks the energy to
initiate social interaction. Sitting quietly with the client communicates
worth and availability without creating overwhelming demands.
Question 2
A client diagnosed with schizophrenia is prescribed clozapine. Which
routine laboratory monitoring is essential for this client to ensure early
detection of a life-threatening hematological adverse effect?
A. Serum creatinine and blood urea nitrogen
, B. Complete blood count (CBC) with absolute neutrophil count
(ANC)
C. Fasting blood glucose and lipid panel
D. Thyroid-stimulating hormone (TSH)
Correct Answer: B
Rationale: Clozapine carries a significant risk of agranulocytosis.
Regular monitoring of the complete blood count and absolute neutrophil
count is mandatory to catch bone marrow suppression early.
Question 3
A client with generalized anxiety disorder reports feeling constantly
tense, irritable, and unable to sleep for the past eight months. Which
medication is commonly prescribed for long-term management without
the risk of physical dependence associated with benzodiazepines?
A. Alprazolam
B. Buspirone
C. Lorazepam
D. Diazepam
Correct Answer: B
Rationale: Buspirone is a non-benzodiazepine anxiolytic used for
chronic anxiety. It does not cause sedation or physical dependence,
though it requires daily scheduled dosing rather than PRN use.
Question 4
,A client with acute mania is pacing the hallway, speaking in rapid, loud,
punning sentences, and refusing to sit down for meals. Which nursing
intervention addresses the client's physical safety and nutritional needs?
A. Insist that the client sit at a large dining table with other residents
until the meal is finished.
B. Provide nutritious, portable finger foods and high-calorie drinks
that the client can consume while pacing.
C. Restrain the client in a chair during meal times.
D. Withhold meals until the client calms down independently.
Correct Answer: B
Rationale: Manic clients often cannot sit still long enough to eat a
traditional meal. Portable finger foods and high-calorie shakes help
maintain adequate caloric and fluid intake during acute hyperactivity.
Question 5
A client with obsessive-compulsive disorder spends hours checking and
rechecking electrical outlets. When the nurse attempts to limit the ritual
to help the client attend group therapy, the client becomes intensely
agitated and panicked. What is the best nursing action?
A. Forcefully block the client from entering the room to stop the
behavior immediately.
B. Allow time for the ritual while gradually setting limits, supporting
the client through the anxiety.
C. Scold the client for being uncooperative with unit rules.
D. Tell the client that outlets are completely safe and their fears are
foolish.
, Correct Answer: B
Rationale: Abruptly stopping compulsive rituals triggers severe panic.
The nurse should allow structured time for rituals initially while
collaborating with the client to gradually reduce time spent on them.
Question 6
A client diagnosed with borderline personality disorder displays splitting
behaviors, telling one nurse that she is the only competent staff member
while accusing the night shift nurse of being cruel and incompetent.
How should the nursing team manage this dynamic?
A. Agree with the client about the incompetence of the night shift
nurse.
B. Establish consistent boundaries, communicate openly among staff,
and avoid taking sides.
C. Punish the client by restricting all visitor privileges.
D. Assign only the favored nurse to care for the client permanently.
Correct Answer: B
Rationale: Splitting pits staff against one another. The nursing team
must maintain clear, consistent boundaries and share open
communication to prevent manipulation.
Question 7
A client is brought to the emergency department after experiencing a
terrifying car accident. The client appears dazed, detached from reality,
and reports feeling as though they are watching themselves from outside
their body. The nurse recognizes this as:
A. Depersonalization / Derealization
Exam 3 Questions and Answers with
Rationale Latest Edition 2026/2027
Question 1
A client is admitted to the psychiatric unit with a diagnosis of major
depressive disorder. The client is withdrawn, uncommunicative, and
sitting in a slumped posture. Which initial nursing intervention is most
therapeutic?
A. Leave the client alone until they feel like initiating a conversation.
B. Sit quietly with the client at frequent intervals, offering a
supportive and non-demanding presence.
C. Engage the client in a high-energy group activity immediately to
distract them.
D. Question the client persistently until they verbalize their
underlying feelings.
Correct Answer: B
Rationale: A withdrawn, depressed client often lacks the energy to
initiate social interaction. Sitting quietly with the client communicates
worth and availability without creating overwhelming demands.
Question 2
A client diagnosed with schizophrenia is prescribed clozapine. Which
routine laboratory monitoring is essential for this client to ensure early
detection of a life-threatening hematological adverse effect?
A. Serum creatinine and blood urea nitrogen
, B. Complete blood count (CBC) with absolute neutrophil count
(ANC)
C. Fasting blood glucose and lipid panel
D. Thyroid-stimulating hormone (TSH)
Correct Answer: B
Rationale: Clozapine carries a significant risk of agranulocytosis.
Regular monitoring of the complete blood count and absolute neutrophil
count is mandatory to catch bone marrow suppression early.
Question 3
A client with generalized anxiety disorder reports feeling constantly
tense, irritable, and unable to sleep for the past eight months. Which
medication is commonly prescribed for long-term management without
the risk of physical dependence associated with benzodiazepines?
A. Alprazolam
B. Buspirone
C. Lorazepam
D. Diazepam
Correct Answer: B
Rationale: Buspirone is a non-benzodiazepine anxiolytic used for
chronic anxiety. It does not cause sedation or physical dependence,
though it requires daily scheduled dosing rather than PRN use.
Question 4
,A client with acute mania is pacing the hallway, speaking in rapid, loud,
punning sentences, and refusing to sit down for meals. Which nursing
intervention addresses the client's physical safety and nutritional needs?
A. Insist that the client sit at a large dining table with other residents
until the meal is finished.
B. Provide nutritious, portable finger foods and high-calorie drinks
that the client can consume while pacing.
C. Restrain the client in a chair during meal times.
D. Withhold meals until the client calms down independently.
Correct Answer: B
Rationale: Manic clients often cannot sit still long enough to eat a
traditional meal. Portable finger foods and high-calorie shakes help
maintain adequate caloric and fluid intake during acute hyperactivity.
Question 5
A client with obsessive-compulsive disorder spends hours checking and
rechecking electrical outlets. When the nurse attempts to limit the ritual
to help the client attend group therapy, the client becomes intensely
agitated and panicked. What is the best nursing action?
A. Forcefully block the client from entering the room to stop the
behavior immediately.
B. Allow time for the ritual while gradually setting limits, supporting
the client through the anxiety.
C. Scold the client for being uncooperative with unit rules.
D. Tell the client that outlets are completely safe and their fears are
foolish.
, Correct Answer: B
Rationale: Abruptly stopping compulsive rituals triggers severe panic.
The nurse should allow structured time for rituals initially while
collaborating with the client to gradually reduce time spent on them.
Question 6
A client diagnosed with borderline personality disorder displays splitting
behaviors, telling one nurse that she is the only competent staff member
while accusing the night shift nurse of being cruel and incompetent.
How should the nursing team manage this dynamic?
A. Agree with the client about the incompetence of the night shift
nurse.
B. Establish consistent boundaries, communicate openly among staff,
and avoid taking sides.
C. Punish the client by restricting all visitor privileges.
D. Assign only the favored nurse to care for the client permanently.
Correct Answer: B
Rationale: Splitting pits staff against one another. The nursing team
must maintain clear, consistent boundaries and share open
communication to prevent manipulation.
Question 7
A client is brought to the emergency department after experiencing a
terrifying car accident. The client appears dazed, detached from reality,
and reports feeling as though they are watching themselves from outside
their body. The nurse recognizes this as:
A. Depersonalization / Derealization
